乙型肝炎肝硬化患者血清IGF-Ⅰ水平与肠道屏障功能损害的关系分析

doi:10.3969/j.issn.1672-5069.2018.04.025

摘要/Abstract

摘要： 目的研究乙型肝炎肝硬化患者血清胰岛素样生长因子Ⅰ（IGF-Ⅰ）水平与肠道屏障功能损害的关系。方法 2015年1月~2017年1月我院诊治的乙型肝炎肝硬化患者107例,其中Child-Pugh A级35例,Child-Pugh B级42例, Child-Pugh C级30例,另选同期健康志愿者40例。采用酶联免疫吸附法检测血清IGF-Ⅰ水平,采用化学比色法检测血清二胺氧化酶（DAO）,采用改良酶学分光光度法检测血清D-乳酸,采用显色基质鲎实验法检测血清内毒素,采用高压液相色谱分析法检测尿液乳果糖/甘露醇（L/M）排出比。结果健康人血清IGF-Ⅰ水平为（217.1±40.2） ng/ml,显著高于Child-Pugh A级肝硬化患者的（180.3±33.4） ng/ml、B级的（152.4±26.5） ng/ml或C级的（126.9±21.8） ng/ml（P<0.05）;健康人血清DAO、D-乳酸、内毒素和尿液L/M比值分别为（2.5±0.5） U/ml、（7.1±1.3）μg/ml、（0.4±0.1） EU/ml和（6.3±1.1）%,显著低于Child-Pugh A级肝硬化患者的（3.3±0.7） U/ml、（9.0±1.6） μg/ml、（0.6±0.1） EU/ml和（9.2±1.7）%或B级的（4.6±0.9） U/ml、（11.2±1.9） μg/ml、（0.8±0.1） EU/ml和（12.6±2.3）%或C级的（5.8±1.0） U/ml、（13.4±2.4） μg/ml、（1.1±0.2） EU/ml和（15.7±2.8）%（P<0.05）;乙型肝炎肝硬化患者血清IGF-Ⅰ与DAO、D-乳酸、内毒素和尿液L/M比值均呈负相关（r=-0.845、r=-0.808、r=-0.867、r=-0.839,P<0.01）。结论乙型肝炎肝硬化患者存在肠道屏障功能损害,检测血清IGF-Ⅰ水平有一定的判断意义。

关键词: 肝硬化, 乙型肝炎, 胰岛素样生长因子Ⅰ, 肠道屏障功能

Abstract: Objective To investigate the relationship between serum insulin-like growth factor I（IGF-I） levels and intestinal barrier damage in patients with hepatitis B liver cirrhosis. Methods 107 patients with hepatitis B liver cirrhosis （35 were of Child-Pugh class A,42 of Child-Pugh class B and 30 of Child-Pugh class C） were recruited in our hospital between January 2015 and January 2017,and 40 healthy volunteers were included at the same period serving as control. Serum IGF-I,diamine oxidase（DAO）,D-lactic acid and endotoxin, as well as excretion ratio of urine lactulose/mannitol（L/M） were detected. Results Serum IGF-I level in the healthy control was （217.1±40.2） ng/ml, significantly higher than [（180.3±33.4）ng/ml in patients with Child-Pugh class A,（152.4±26.5）ng/ml in Child-Pugh class B or（126.9±21.8）ng/ml in Child-Pugh class C,all P<0.05）;serum DAO,D-lactic acid and endotoxin levels,and L/M ratio in the healthy control were （2.5±0.5） U/ml,（7.1±1.3） μg/ml and （0.4±0.1） EU/ml,and （6.3±1.1）%,significantly lower than [（3.3±0.7）U/ml,（9.0±1.6）μg/ml and （0.6±0.1）EU/ml,and （9.2±1.7）% in patients with Child-Pugh class A,or （4.6±0.9）U/ml,（11.2±1.9）μg/ml and （0.8±0.1）EU/ml,and （12.6±2.3）% in Child-Pugh class B or （5.8±1.0）U/ml,（13.4±2.4）μg/ml and（1.1±0.2）EU/ml, and（15.7±2.8）% in Child-Pugh class C, all P<0.05];serum IGF-I level in patients with liver cirrhosis was negatively correlated with serum DAO,D-lactic acid,endotoxin and urine L/M ratio（r=-0.845,r=-0.808,r=-0.867,r=-0.839, P<0.01）. Conclusion Patients with hepatitis B liver cirrhosis have damaged intestinal barrier, and serum IGF-I level might reflect it in this setting.

Key words: Liver cirrhosis, Hepatitis B, Insulin-like growth factor I, Intestinal barrier function

周文浩, 蒋晓忠, 王昌松, 黄斌. 乙型肝炎肝硬化患者血清IGF-Ⅰ水平与肠道屏障功能损害的关系分析[J]. 实用肝脏病杂志, 2018, 21(4): 585-588.

Zhou Wenhao, Jiang Xiaozhong, Wang Changsong, et al. Relationship between serum IGF-I levels and intestinal barrier damage in patients with hepatitis B cirrhosis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2018, 21(4): 585-588.

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